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Sodium Thiosulfate Fails to Reduce Nitrite‐induced Methemoglobinemia in Vitro
Author(s) -
Matteucci Michael John,
Reed William Job,
Tanen David Alan
Publication year - 2003
Publication title -
academic emergency medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.221
H-Index - 124
eISSN - 1553-2712
pISSN - 1069-6563
DOI - 10.1111/j.1553-2712.2003.tb01339.x
Subject(s) - methemoglobin , medicine , methemoglobinemia , serial dilution , sodium thiosulfate , sodium nitrite , nitrite , hemoglobin , anesthesia , food science , chemistry , pathology , inorganic chemistry , alternative medicine , organic chemistry , nitrate
Objectives: To determine whether sodium thiosulfate (STS) produces a clinically significant decline in sodium nitrite‐induced methemoglobinemia in an in‐vitro model. Methods: This was an in‐vitro, controlled study where methemoglobinemia was induced by the addition of sodium nitrite (0.4 mg/mL) to 35‐mL aliquots of blood obtained from ten healthy volunteers. Methemoglobin (MetHb) concentrations were measured at 5‐minute intervals for 30 minutes by co‐oximetry, and each aliquot was then subdivided into six 5‐mL samples (time zero). Sample 1 served as control. The remaining samples received serial dilutions of STS (0.125 mg, 1.25 mg, 12.5 mg, 125 mg, 1,250 mg). MetHb concentrations were measured by co‐oximetry at baseline, 0, 15, 30, 45, and 60 minutes. Areas under the MetHb concentration–time curve (AUC) between time zero and 60 minutes were compared using the Kruskal‐Wallis test. Results: Methemoglobin concentrations increased from 0.07 g/dL (±0.06) at baseline to 8.42 g/dL (±0.69) at time 0 (the addition of STS). No significant difference was detected between baseline and time 0 hemoglobin concentrations (15.8 ± 0.5 vs. 16.1 ± 0.6 g/dL). There was no detectable difference found between the AUCs (measured in g min/dL) of any of the STS serial dilutions or control groups (0.125 mg STS = 576.01 ± 42.53; 1.25 mg STS = 573.47 ± 40.82; 12.5 mg STS = 583.68 ± 42.29; 125 mg STS = 554.75 ± 42.68; 1,250 mg STS = 566.95 ± 38.08; p = 0.81). Conclusions: Sodium thiosulfate was not found to be an effective reducing agent for the acute treatment of methemoglobinemia.